Consultation backs EU action on health
services

The majority of contributors to the Commission's
recent consultation favour some form of Community action on health services,
combining both legislative elements and practical support for cooperation
between European health systems. EU Health Commissioner Markos Kyprianou
presented the results of this consultation today to the Informal Health Council
in Aachen, Germany. Contributors saw a need for better information to patients
to enable informed choices about cross-border care and greater clarity about the
procedures to follow, with a broad consensus that quality and safety of
healthcare should be ensured by the country where treatment is provided.

Commissioner Kyprianou said: "These contributions provide a solid basis for
proposals to clarify rules for cross-border care, to create important and
positive synergies in the health sector from European cooperation and to help
improve healthcare provision throughout the Union."

Key results from the responses to the consultation include:

The scale of cross-border healthcare is limited – many contributors
agreed with the Commission's estimate that overall it represents about 1% of
total healthcare expenses. But it is larger in some cases (for example in
border regions, smaller Member States, for rare diseases and areas with high
numbers of visitors from abroad) – and it is expected to grow;

Greater clarity was seen as needed over limits of cross-border healthcare
under Community law, in particular when prior authorisation can be required or
refused. Suggestions by contributors included clear information for patients;
effective and transparent decision procedures; a patient-centred approach;
evidence-based standards; the right to appeal against refusals; and easier
procedures for border regions;

Many contributors saw value in European support to improve further the
level of quality and safety in healthcare, such as through developing guidelines
and indicators. Other suggestions included developing systems for exchanging
patient data between countries, an EU standard discharge letter, Europe-wide
prescriptions, and establishing arbitration or mediation systems regarding
compensation for any harm arising from cross-border care;

Suggestions for practical European support to national health systems
included European networks of centres of reference; an observatory for
comparative data and indicators; better sharing of healthcare innovations; and
support for health investment through the structural funds.

Many
contributors felt that any Community action should be based on the common values
(universality, access to good quality care, equity and solidarity) and
principles (quality, safety, care that is based on evidence and ethics, patient
involvement, redress, privacy and confidentiality) of EU health systems (as set
out notably by the Council in June 2006). A majority of contributors also felt
that a combination of supportive practical tools and legally binding measures
would be best.

Regarding the nature of any legal instrument, opinions were divided, with the
two main options being to include any changes within the existing regulations on
the coordination of social security systems, while other contributors preferred
a new specific directive on health services in order to tackle also issues
pertaining to areas falling outside the scope of these regulations.

The background

Responding to the request by many healthcare stakeholders for greater clarity
over what Community law means for health services, the Commission launched a
public consultation process on 26 September 2006 regarding Community action on
health services. Over 270 responses have been received from national
governments, regional authorities, international and national umbrella
organisations, social security institutions, universities, industry and
individual citizens. The report released today represents the
Commission’s summary of these responses, not the views of the Commission
itself. The Commission intends to bring forward proposals for Community action
on health services toward the end of 2007.

Further information

The summary report and all individual responses to the consultation regarding
“Community action on health services” are available at: